This is a venous eczema. This common form of eczema is associated with venous insufficiency. It is thought to be caused by fluid accumulating in the legs and triggering an immune response. The condition is most often seen in older age groups: 20 of those over 70 years of age are affected, with women more commonly affected than men. Risk factors include a history of deep vein thrombosis, cellulitis, varicose veins, venous leg ulcers and chronic leg swelling. Complications may include cellulitis, and secondary contact allergy to treatments used for the condition. The diagnosis is usually clinical. Features include an itchy rash, dry scaly plaques, orange-brown pigmentation owing to haemosiderin deposition, induration, lipoderma-tosclerosis (inflammation of the subcutaneous fat causing fibrosis, and hard, tight red/brown skin), atrophie blanche (white, atrophie areas surrounded by red areas) and a 'champagne bottle" shape of the lower leg. One or both legs may be affected.
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